Welcome to AIM

Frequently Asked Questions

1. What do I do if my income is less than the AIM guidelines?
   If your income is less than the AIM guidelines you may be eligible for no cost Medi-Cal. Look in your local telephone White Pages for the Department of Social Services office near you to receive more information about Medi-Cal.
   
2. Can I send in a personal check with my application?
   No, personal checks are not accepted with the application. You must submit either a money order or cashier’s check made payable to the AIM program.
   
3. Can I fax my application?
   No, your original signature on the application and a money order or cashier’s check are required along with copies of your income documentation and pregnancy certification.
   
4. Can I send copies of the application?
   You can use a copy of the application as long as the copy you send has your original signature. Send copies of your income documents and pregnancy certification instead of originals.
   
5. Can I apply in person? If not, where do I mail my AIM application?
   No, you can not apply in person. All applications are processed via mail. Applications can be sent in via regular or priority mail to: California Access for Infants and Mothers Program, P.O. Box 15559, Sacramento, CA 95852-0559. Applications can be sent via overnight mail to: Access for Infants and Mothers Program, 625 Coolidge Drive Ste 100, Folsom, CA 95630.
   
6. Do I count my husband's income if he works away from home in another city, state, or country several months of the year?
   Yes, if he is claiming that he lives in the home with the pregnant woman.
   
7. Do I count the father of the baby and his income?
   No, except if you already have a child in common.
   
8. How soon will I know when I’m enrolled?
   Normal processing time for a complete application is 10 days. You will receive a letter from the AIM Program once enrolled. If the application is incomplete, you will receive a letter requesting the additional information needed and the processing time will be longer. You will receive an evidence of coverage booklet and an insurance card from the health plan you selected once enrolled in AIM. The effective date of coverage is 10 days after enrollment.
   
9. Can I send copies of my income documentation?
   Yes, do not send originals.
   
10. How soon can I see a doctor through AIM?
    As of the effective date of coverage. However, keep in mind that you must call the doctor to make an appointment.
    
11. What are the benefits of having AIM as opposed to pregnancy-related restrictive Medi-Cal only?
    AIM offers comprehensive benefits, including pregnancy and non-pregnancy related service. For more information, you can request a copy of the evidence of coverage from the Health Plan of your choice.
    
12. Do I still have a co-payment when I go to the doctor?
    No, AIM does not have co-payments or deductibles.
    
13. Will AIM pay for birth control after my baby is born?
    Refer to your Health Plan’s benefits chart and evidence of coverage.
    
14. Can I see a doctor in a county neighboring the one in which I live?
    You should contact your Health Plan to see if they will allow you to see a specific provider.
    
15. Will I receive a refund check from AIM if I am not eligible?
    A refund check from the AIM Program will be mailed
    to you.
    
16. Will AIM cover high risk pregnancies?
    Yes.
    
17. Can I continue to see my current doctor?
    It depends. Please call your Health Plan to find out if the doctor is an AIM participating provider.
    
18. Are vision and dental covered with AIM?
    Refer to your health plan’s benefits chart.
    
19. If I have to pay 20% of my hospital bill, is that considered more than a $500 deductible?
    It depends on the cost of the delivery.
    
20. Can I change doctors if it doesn’t work out with my new AIM doctor?
    Any requests to transfer doctors must be made through the Health Plan.
21. Is the work deduction taken if I’m not working now, but I worked last year and I'm using that income to qualify me for the program?
    A work deduction is used for the period in which income documentation is received.
    
22. Do I list my children if they live with me only half of the time?
    Yes, if they are claimed as dependents on your federal or state tax return.
    
23. Does my husband and I have to use income from the same year?
    No. Either spouse can use previous year’s income or current income.
    
24. What is gross income after deductions?
    The first step in determining eligibility is to look at gross income (before taxes). The Program then subtracts any applicable deduction (see a list of allowable deductions). These deductions are mandatory.
    
25. Who selects my provider and the hospital at which I will deliver my baby?
    The pregnant woman can select her provider through the health plan. Depending on the health plan contract, the provider will inform you of the hospital where you will deliver your baby.
    
26. How is self-employed income calculated?
    The AIM Program uses net profit income to determine eligibility (gross income minus business expenses). There are two options to show income for self-employed individuals. They may submit last year’s Federal Income Tax Form 1040 with the Schedule C. Or they may submit the most recent 3 month Profit and Loss Statement. Any deductions for meals/entertainment and/or depreciation are added back into the net profit income. Any losses (negative dollar amounts) are counted as zero ($0).
    
27. How do I obtain a non-obstetrical specialist while in the AIM Program?
    Call your health plan’s customer or member services. If you are in an EPO, you can do a self referral. If you are in an HMO, you need to obtain a referral from your primary care provider.
    
28. How can I find out if my obstetrician and delivering hospital are part of the AIM Program?
    Call your health plan’s customer or member services, or refer to your health plan’s provider directory.
    
29. Can I transfer to a different health plan if my doctor or delivering hospital is no longer recognized as an AIM provider by my original health plan?
    No. If your obstetrician or delivering hospital is no longer contracting with your current health plan, call your plan’s customer or member services for assistance. The plan will either assist you in choosing a new provider or hospital, or allow you to continue seeing your current obstetrician and delivery hospital to provide continuity of care.
    
30. Can I obtain brand name drugs when a generic
    substitution is available for my prescriptions?
    Only if the provider indicates that the brand name drug cannot be substituted with a generic drug.
    
31. Will the AIM Program cover treatment for delivery complications beyond 60 days following delivery of my infant?
    No. Pregnancy related treatment is covered for a maximum of 60 days following delivery of your baby.
    
32. How do I obtain urgent or emergency care during non-business hours?
    Call your Primary Care Provider or your Medical Group. The answering service will connect you with the advice nurse or the doctor on call to give you further directions.
    
33. How does private insurance coverage affect my AIM Program coverage?
    Having private insurance should not affect your coverage as long as you have a deductible specifically for maternity services of $500 or more. You must use the AIM health plan network providers in order for the AIM health plan to cover services.
    
34. What if my pregnancy is unsuccessful?
    If your pregnancy ends on or after your coverage starts, you are still responsible for paying the 1.5% contribution amount. However, you will be covered for 60 days after the pregnancy ends. If you are no longer pregnant on your start date of coverage and notification to the program is received after the start date of coverage, documentation by a licensed or certified health care professional must be submitted indicating the date your pregnancy ended.
35. What if my pregnancy ends in the first trimester?
    If your pregnancy ends within your first trimester on or after your coverage starts, you may be eligible for a reduced contribution. You need to notify the AIM Program within 30 days of the end of your pregnancy. The AIM Program will need the complete Early End of Pregnancy Form or send a letter from a doctor or other licensed or certified health care professional, as long as it contains the same information. If you provide the necessary information to AIM, you will be notified if you qualify for the lower amount of 1/3 of the original cost.
36. What if I don’t notify AIM that my pregnancy ended within 30 days?
    You still need to notify the AIM Program that your pregnancy ended. If you do not tell AIM that your pregnancy ended within 30 days, you will not receive timely notification of your disenrollment. Your coverage will still end 60 days after the end of your pregnancy.
37. What if I don’t notify AIM that my pregnancy ended within 60 days?
    You still need to notify the AIM Program that your pregnancy ended. If you do not tell AIM that your pregnancy ended within 60 days after the end of your pregnancy, the AIM Program will retro-disenroll you. The AIM Program cannot cover medical services received 60 days after the end of your pregnancy.
38. What if I have medical bills 60 days after the end of my pregnancy?
    If you receive medical services 60 days after the end of your pregnancy, AIM will not pay for these services. If you have other health coverage, you will need to call them to see if they will help with those medical bills. You will be responsible for any medical services you receive after 60 days from the end of your pregnancy.
39. What if I need more than 60 days after the end of my pregnancy?
    AIM cannot pay for any services received 60 days after the end of your pregnancy. If you need other health coverage, you may see if you qualify for Medi-Cal or the Major Risk Medical Insurance Program. Look in your local telephone white pages for the Department of Social Services office near you to receive more information about Medi-Cal. You may also call the Major Risk Medical Insurance Program at 1-800-289-6574.